Journal of the American College of Radiology : JACR
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Recent proliferation of mobile diagnostic ultrasound (US) units and improved resolution have allowed for widespread use of US by more providers, both for diagnosis and US-guided procedures (USGP). This study aims to document recent trends in utilization for USGP in the Medicare population. ⋯ The year 2010 represents the first year that nonradiologists performed more USGP than radiologists. From 2004 to 2010, radiologists and surgeons experienced only modest growth in USGP volume, whereas several other provider types experienced more rapid growth. It is likely that many procedures that were previously performed without US guidance are now being performed with US guidance.
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Processes for credentialing physicians and criteria used for delineating their practice-specific clinical privileges vary widely across the United States. The ACR and the ABR have jointly developed this resource document to define the requisite credentials for specialty board-certified diagnostic radiologists and subspecialty board-certified nuclear radiologists to be privileged to practice therapeutic nuclear medicine. ⋯ On the basis of their education, training, and clinical work experience, board-certified radiologists have the qualifications to supervise and perform therapies using unsealed radioisotopes. Optimum patient care is best served by a physician with training and expertise in supervising and performing radioisotope therapies in conjunction with multimodality imaging technologies for initial diagnosis and follow-up.
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Transition from film-screen to digital radiography requires changes in radiographic technique and workflow processes to ensure that the minimum radiation exposure is used while maintaining diagnostic image quality. Checklists have been demonstrated to be useful tools for decreasing errors and improving safety in several areas, including commercial aviation and surgical procedures. ⋯ The checklist and its accompanying implementation manual and practice quality improvement project are open source and downloadable at www.imagegently.org. The authors describe the process of developing and testing the checklist and offer suggestions for using the checklist to minimize radiation exposure to children during radiography.
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The aim of this study was to determine what proportion of noninvasive diagnostic imaging (NDI) work done by radiologists occurred in each of the 4 primary places of service where imaging is conducted. ⋯ Radiologists' workload in hospital outpatient and inpatient facilities and offices grew from 2000 through 2006, but no further growth occurred thereafter. EDs were the only venue where growth continued. The vast proportion of radiology NDI RVUs (81% in 2011) are produced in hospital settings.
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Radiation therapy plays a potential curative role in the treatment of patients with non-small-cell lung cancer with locoregional disease who are not surgical candidates and a palliative role for patients with metastatic disease. Stereotactic body radiation therapy is a relatively new technique in patients with early-stage non-small-cell lung cancer. A trial from RTOG(®) reported >97% local control at 3 years. ⋯ The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.